Fitness Assessment

You want to find out how you can get closer to achieving your goal. Take a moment to complete this fitness assessment and see where you are and find out what little adjustments you can make to get where you want to be.

It is easier than you realize to increase the amount of exercise that you are getting throughout the day. Even if you can only work in two to three short ten to fifteen minutes sessions per day. Every little activity helps no matter how small, it adds up. I can share with you information I can gained along my journey that has helped me succeed in mainaining a weight loss of 55 pounds.

Now is your chance, take the assessment below.

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in

Fitness Assessment

Please note that all fields followed by an asterisk must be filled in.

First Name*

E-Mail Address*

Do you enjoy any of the following?

Gardening

Cleaning

Dancing

What are your fitness goals?

Better Health

Weight Loss

Less Stress/More Energy

How often do you work out?

3 to 5 days per week

less than 3 days

I don't work out.

How do you work extra exercise into your day?

Walk the stairs at work instead of taking the elevator.

Park away from the door at the store or office.

Take a stroll at lunch/break.

Do you have a formal exercise program?

I work out at home.

I work out at the gym.

I don't have time to work out.

Tell me a little about your activites.

Enter your E-mail Address

Enter your First Name (optional)

Then

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